2015 ISAKOS Biennial Congress ePoster #1106

The Effects of the Use of the Medial Arch Support on Kinematics and Kinetics During Single-Leg Squat in the Patients With the Anterior Knee Pain Syndrome

Satoshi Kotake, Physiotherapist, Hakodate, Hokkaido JAPAN
Takumi Ino, Physiotherapist, Assoc. Prof., Sapporo, Hokkaido JAPAN
Yuhei Ohsumi, Physiotherapist, Hakodate, Hokkaido JAPAN
Kengo Ukishiro, BPT, MHSc, Hakodate, Hokkaido JAPAN
Toshinori Yoshida, Physiotherapist, Hakodate, Hokkaido JAPAN
Tatsunori Maeda, MD, Hakodate, Hokkaido JAPAN
Ko Suzuki, MD, Hakodate, Hokkaido JAPAN
Kensaku Kawakami, PhD, Assoc. Prof., Hakodate, Hokkaido JAPAN
Shoji Suzuki, PhD, Assoc.Prof., Hakodate, Hokkaido JAPAN
Tomoya Moriguchi, Prosthetist and Orthotist, Sapporo, Hokkaido JAPAN
Harukazu Tohyama, MD, PhD, Sapporo, Hokkaido JAPAN
Yasumitsu Ohkoshi, MD, Hakodate, Hokkaido JAPAN

Hakodate Orthopedic Clinic , Hakodate, Hokkaido, JAPAN

FDA Status Not Applicable

Summary: This study showed that the use of medial arch support significantly reduced the moment of knee abduction, knee external rotation, ankle pronation and ankle abduction moments during single-leg squat in the patients with anterior knee pain.




It is well known that excessive pronation with the flat feet is responsible of anterior knee pain. The insoles with medial arch support (MAS) are widely used to reduce the symptoms of the patients with anterior knee pain. However, the understanding of the biomechanical effects of the MAS on kinematic or kinetics in the patients with anterior knee pain is limited. The purpose of this study was to investigate the effects of the use of MAS on kinematics and kinetics of the lower extremity in anterior knee pain patients.


Twelve patients (five males and seven females; mean ± SD age: 15.0 ± 1.9 years; height:1.63 ± 9.36 m; weight: 54.63 ± 11.1 kg) who had anterior knee pain after sports activities participated in this study. Informed consent was obtained from all patients before measurement and IRB approved this study. The patients performed single leg squat at self-selected speed in each of two experimental conditions; 1) the regular running shoes with MAS and 2) barefoot. Three-dimensional kinematic data were collected using the point cluster technique with four cameras (ProReflex, Qualisys AB Inc., Gothenburg, Sweden). Ground reaction force data were collected using two force plates (OR6, Advanced Mechanical Technology Inc., Watertown, New York) at 120Hz. External knee joint moment was calculated by inverse dynamics, and it was standardized by height and weight for each subject. For statistical analysis, paired t-tests were performed to differences between kinematic and kinetic data of the knee joint with MAS and barefoot. Differences were considered statistically significant at P < .05.


The peak knee flexion angle was significantly greater in the condition with MAS than the barefoot condition (P<0.001). The average range of internal-external rotation of the knee was smaller in the condition with MAS than the barefoot condition, while we did not detect a statistical difference between the conditions with and without MAS (P=0.08). Concerning kinetic data, the use of MAS significantly reduced the peak knee abduction moment (P=0.006), the peak knee external rotation moment (P<0.001), the peak ankle pronation moment(P=0.001)and the peak ankle abduction moment(P<0.001).


The present study showed that the use of MAS significantly affects kinematic and kinetic changes of the knee and ankle joints during single-leg squat in the patients with the anterior knee pain syndrome. These findings suggest that the use of the MAS may improve the posture of the legs and change the direction of the ground reaction forces during single-leg squat. The decreases in the knee abduction and the tibial external-roation moments may alleviate the stresses of the soft tissues surrounding the knee, which possibly induces the symptom during athletic activities in the anterior knee pain patients.